What Is Dementia?
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Medically reviewed by Smita Patel, DO
Dementia is an umbrella term for multiple neurological (brain-related) conditions that cause a loss of cognitive functions. These functions include your ability to think clearly, remember certain details, and make reasonable decisions. Dementia becomes more common as people age; of the 55 million people around the world with dementia, about one-third are over the age of 85.
There are many different kinds of dementia, with Alzheimer’s disease being the most common and well-known. Unfortunately, dementia is a degenerative disease that gets worse over time and has no cure. However, some treatments can help people with dementia manage their symptoms and improve their quality of life, especially if they get medical care early on.
Types of Dementia
There are many different types of dementia based on the reason for your decline in cognitive abilities. However, all dementias occur due to some kind of changes in the brain:
Alzheimer’s disease: Abnormal protein build-up in the brain might cause this type of dementia. Damage in cells and nerves can affect memory and other brain functions. Most people with Alzheimer's disease are usually over the age of 60.
Vascular dementia: Some conditions, like blood clots and stroke, can affect the flow of blood to the brain and cause permanent damage, resulting in dementia.
Frontotemporal dementia: Similar to Alzheimer’s, an abnormal protein build-up causes this type of dementia. This build-up occurs specifically in the frontal and temporal lobes of the brain (behind the forehead and the ears) and can cause behavioral changes.
Lewy body dementia: This dementia gets its name from the specific proteins, called “Lewy bodies” that accumulate in the brain and destroy nerve cells.
Mixed dementia: This is a medical term for the diagnosis of two different types of dementia at the same time. It's more common in people over the age of 80.
Other dementias: Less commonly, you might have dementia associated with another brain disorder, like Parkinson’s disease (a neurological disorder that affects motor function), early onset dementia (before the age of 65), or dementia caused by a reversible condition, like vitamin deficiency or hormone imbalance.
Dementia Symptoms
The types of dementia have various causes and often affect different areas of the brain, so symptoms are not the same across all dementias. Most people with dementia will experience one or more common symptoms, such as memory loss, impulsivity, and difficulty communicating. These are the typical warning signs of the four primary types of dementia:
Alzheimer’s disease: Memory loss, mood swings, difficulty naming everyday objects, forgetting familiar people, loss of communication skills, confusion about everyday tasks, wandering away from safe places or becoming lost, personality changes, and disturbing or unusual behaviors
Vascular dementia: Memory loss, confusion, loss of reading, writing, and communication skills, impulsivity or loss of inhibitions, personality changes, losing items or becoming lost easily, and difficulty following directions, performing typical tasks, or learning new skills
Frontotemporal dementia: Behavioral changes like impulsivity or inappropriate emotional responses, coordination issues such as shaky hands and loss of balance, and communication difficulties like inability to understand speech
Lewy body dementia: Loss of reasoning skills, disrupted sleep, hallucinations or delusions, tremors, and changes in visual perception
Causes
Generally, a loss of important brain cells called neurons is related to the onset of dementia. Neurons communicate with each other, but when they stop communicating, they die—and a person experiences cognitive effects as a result.
It's normal for neurons to decrease with age, but dementia occurs when neurons decline at much higher rates than normal and the brain can no longer work properly. For the most part, researchers don’t know why some people develop dementia while others don’t, though they have identified some risk factors.
Risk Factors
The causes of dementia are still largely unknown, but some things are associated with a higher risk of developing dementia, such as:
Age over 65
Family history of dementia
Personal history of underlying conditions like depression, hearing impairments, diabetes, heart disease, and hypertension (high blood pressure)
Being of Black or Latino descent
History of traumatic brain injury (TBI) or concussion
Social isolation and loneliness
Lifestyle habits such as being physically inactive, smoking, drinking alcohol excessively, and regularly not getting enough sleep
Diagnosis
If you or a loved one are experiencing changes in memory or behavioral concerns, seeing a healthcare provider is an important first step. Sometimes a physical exam or psychiatric evaluation by a healthcare provider can identify an underlying cause for dementia symptoms—like a medication or other health condition. To make a diagnosis of dementia, your provider will likely:
Learn about your personal and family history
Perform a physical exam
Check your bloodwork
Order cognitive tests to assess brain function
Recommend an imaging scan of your brain to identify any abnormalities
Refer you to a psychiatrist for a mental health evaluation to rule out other causes of behavioral or emotional disturbances
Complete a genetic screening test or a cerebrospinal fluid test to get more specific information about the type of dementia that's causing your symptoms
Stages of Dementia
A neurologist (a doctor who specializes in brain and spinal cord disorders) will likely play a significant role in the diagnostic process. They can help place you into the correct stage of dementia based on your testing results. Dementias typically fall into one of three categories.
Early | Middle | Late |
Mild memory loss (like losing everyday items or forgetting names) | *Usually the longest stage, with worsening symptoms, including: Not recognizing family members Difficulty with speech Agitation Poor sleep Confusion about time and place Hallucinations | *Person typically needs full-time care May not be able to communicate very much at all May not recognize themselves in a mirror Might become depressed or aggressive Might require assistance with meals and personal care |
Treatment
Unfortunately, researchers have not yet found a cure for dementia. Current treatments focus on helping people manage their symptoms and improve their overall quality of life.
The earlier you or your loved one starts treatment, the better the treatment can work to slow down the progression of this disease.
Medications
Medications can help reduce the symptoms of dementia or, in some cases, help slow down the loss of cognitive function. These include:
Anti-amyloid medications: Target and help remove some protein build-up in the brain that causes certain types of dementias. One of these drugs, Aduhelm (aducanumab), will be discontinued in 2024 because the company can no longer fund its production. Fortunately, another drug called Leqembi (lecanemab) works similarly and is still being manufactured.
Symptom-based medications: Drugs to treat memory and cognition problems are an option for some people. These drugs include cholinesterase inhibitors and glutamate regulators, both of which improve the brain’s ability to send chemical messages related to memory and learning. These medications may also treat symptoms of insomnia, anxiety, aggression, and hallucinations or paranoia.
Behavioral Management
Living with dementia makes it extremely difficult for the person living with dementia to control their behaviors. Caregivers can learn simple techniques to reduce certain reactions or responses from their loved ones. This is not a traditional “treatment,” but adopting certain strategies when communicating with a person with dementia can help keep them calmer and less prone to symptoms like aggression and agitation. Here are some suggestions:
Stick to the same routine each day
Give the person with dementia as much independence as they can safely have
Introduce calming sensory input, like soothing music and gentle walks
Avoid arguing or disputing facts
Acknowledge their feelings
Communicate with simple statements and questions
Redirect and distract when emotions become heightened
Clinical Trials
Clinical trials help researchers understand how to treat dementia better and advance new forms of treatment. Though there are potential risks and not every person with dementia is a candidate for a clinical trial, participating in a trial can give a person with dementia access to new treatments—including medications, interventions, and therapies—that may help slow the progression of their disease.
Keep in mind: treatments during a clinical trial haven't been officially approved for public use yet, as they're being tested to see if the treatments work.
How To Prevent Dementia
You can't prevent dementia, especially since primary risk factors like aging and a family history of dementia aren't within your control. However, experts agree that taking good care of your body and brain can reduce your risk of developing dementia as you age. This includes:
Getting regular exercise
Controlling your blood pressure and blood sugar
Engaging your brain with memory-boosting activities (like puzzles, crafts, and hobbies)
Staying socially connected to others
Managing existing health conditions, like hearing loss, obesity, and diabetes
Limiting alcohol and tobacco use
Wearing protective equipment to prevent brain injury
Related Conditions
Dementia can cause or be caused by other health conditions; in fact, most people with dementia have at least two other diseases or disorders. Related conditions commonly include:
Diabetes: When left untreated, long-term insulin resistance (a marker of diabetes) can reduce brain function and even cause vascular (blood vessel-related) brain injury.
Hypertension: High blood pressure affects the body’s vascular system, which can increase the risk of stroke, dementia, and general cognitive decline.
Heart disease: A 2017 study found a correlation between risk factors for heart disease—like smoking, obesity, and high cholesterol—and an increased risk of developing dementia. These factors cause damage to the body’s blood vessels, including those in the brain, which may lead to cognitive impairment.
Depression: Depression rates are high for people with any type of dementia. Dementia symptoms cause a person to become depressed, and having a major depressive episode is a risk factor for developing dementia.
Living With Dementia
People with dementia live, on average, about 4-8 years after the disease begins, but that number can be variable. If you develop dementia earlier (like at age 70 versus age 85, for example), your lifespan may not be shortened. Other factors include your support network and how early in the disease you began receiving treatment.
It can be extremely stressful and challenging to live with dementia or care for someone with dementia, but there are ways to make life easier, including:
Automating everyday services, such as setting up payments for bills or grocery deliveries
Making the home safer, like reducing the risk of falls or injuries
Lifestyle habits like getting regular exercise, eating nutrient-rich foods, and increasing your support network of family and friends
There are many services in the community available to people with dementia and their families, including state assistance programs and home health aids. Although many people end up requiring full-time care, utilizing some of the treatments approved for dementia can help a person maintain their quality of life for longer.
Frequently Asked Questions
What should you do if you or a loved one have early dementia symptoms?
An early dementia diagnosis can improve how the condition is managed. Meet with a trusted healthcare provider and discuss your concerns if you think you have symptoms. If you think your loved one is affected, try to meet as a family and talk about the changes you’ve noticed and encourage them to see a provider for evaluation.
Is dementia the same as Alzheimer's disease?
Alzheimer’s disease is a type of dementia. Dementia refers to a group of symptoms caused by changes in the brain, and encompasses several other types of dementia in addition to Alzheimer’s disease.
What is the life expectancy for someone with dementia?
The life expectancy of someone with dementia depends on the cause of dementia, as well as the age and gender of the person with the condition. On average, the lifespan of someone with dementia is about 4-8 years.
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